Combined oral contraceptive pills combine two female hormones, estrogen and different generations of progestins, resulting in various oral contraceptive options, as outlined below:
1. Norgestimate + ethinyl estradiol
Available as generic versions Sprintec, Estarylla, or Femynor, is the most commonly prescribed oral contraceptive medication. V.ARIA recommends generic medications for cost-effectiveness.
Norgestimate, a third-generation progestin, exhibits high progestational activity with minimal estrogenic and androgenic effects. Its low androgenic effects make it suitable for individuals with acne concerns. Notably, birth control pills containing norgestimate are the only ones FDA-approved for acne management.
The cost of the most common generic medication version, with a coupon, is approximately $7.28, representing a 49% discount from the average retail price of $14.32.
2. Drospirenone + Ethinyl Estradiol
Available as generic versions Yaz, Gianvi, Jasmiel, Vestura, Nikki, Lo-Zumandimine, or Loryna, is also FDA-approved for PMDD treatment. However, V.ARIA does not prescribe birth control solely for non-contraceptive use.
Drospirenone is associated with an increased risk of blood clots, making it an unsuitable choice for individuals with clotting risk factors. It also has low androgenic activity and may elevate potassium levels, making it unsuitable for individuals with kidney, liver, or adrenal issues.
With a coupon, the most common generic medication version costs approximately $12.46 per month, an 83% reduction from the average retail price of $76.86. Branded Yaz is also available at affordable prices compatible with generic versions, with the lowest price, using a coupon, around $51, representing a 75% discount from the average retail price of $200 to $237.
3. Desogestrel + ethinyl estradiol combination
Avavailable as generic versions Desogen, Apri, Emoquette, Mircette, Solia, Enskyce, or Juleber, offers another estrogen and progestin combination. Desogestrel, a third-generation progestin, possesses high progestational activity, reducing androgenic and estrogenic effects. It has less impact on weight gain and acne compared to other options. Like drospirenone, desogestrel has a higher risk of blood clots. The most common generic medication version, with a coupon, costs approximately $15.20, a 78% reduction from the average retail price of $70.24.
4. Norethindrone + Ethinyl estradiol; Ferrous fumarate
Available as generic versions Junel FE 1/20, Microgestin FE 1/20, Loestrin FE 1/20, Larin FE 1/20, Hailey FE 1/20, Gildess FE 1/20, Tarina FE 1/20, or Aurovela FE 1/20, offers a low estrogen activity option. Loestrin and Microgestin are also available as branded versions with prices compatible with generic versions.
Norethindrone, a first-generation progestin, exhibits low progestational and minimal estrogenic activity. It is less androgenic than second-generation progestins (levonorgestrel and norgestrel) but more androgenic than newer progestins like desogestrel.
The most common generic medication version, with a coupon, costs approximately $19.03, a 77% reduction from the average retail price of $85.79.
5. Norethindrone pills
This is for individuals seeking a progestin-only pill (POP) with no estrogen component, available as a generic version of Micronor, Camila, Errin, Deblitane, Jencycla, Norlyda, Heather, Jolivette, Nora-Be, or Lyza, offer a viable choice.
This option carries a lower risk of serious side effects compared to combination pills and is suitable for those with a history of high blood pressure or clotting risk factors.
The most common generic medication version, with a coupon, costs approximately $13.32, an 86% reduction from the average retail price of $97.38.
6. Levonorgestrel + Ethinyl estradiol
Available as a generic version of Seasonique, Simpesse, Daysee, Amethia, Camrese, Jaimiess, or Ashlyna, offers an extended-cycle birth control pill option. It comprises 84 days of two combined pills followed by 7 days of pills containing a low estradiol dose.
This option allows menstrual periods every 90 days (approximately 3 months) for those who wish to avoid monthly menstruation. Levonorgestrel, a second-generation progestin, is widely prescribed worldwide, featuring high progestational and androgenic effects.
It has the lowest blood clot risk among all combined oral contraceptives, making it suitable for individuals with clotting risk factors. However, it may increase androgenic side effects like acne.
The most common generic medication version, with a coupon, costs approximately $21.25, an 85% reduction from the average retail price of $143.19. Additionally, there are monophasic options available for 28 days of treatment, such as Levora, Nordette, Altavera, Chateal, Kurvelo, or Marlissa, with a daily dose of 0.15mg/30mcg and an inert pill week in the fourth week.